Provider Demographics
NPI:1780808378
Name:LUDDEN, WILLIAM R (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:LUDDEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7799 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38053-2431
Mailing Address - Country:US
Mailing Address - Phone:901-872-8151
Mailing Address - Fax:901-872-3540
Practice Address - Street 1:7799 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38053-2431
Practice Address - Country:US
Practice Address - Phone:901-872-8151
Practice Address - Fax:901-872-3540
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN93361223G0001X
CO65201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice